MEDICARE: BARBARA JEAN THOMPSON PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	2166	MD

General Provider Information

NPI Number	:	1194722363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA JEAN THOMPSON PHD

Provider Business Mailing Address
First Line	:	17205 LIGHTFOOT LN
Second Line	:
City	:	POOLESVILLE
State	:	MD
Zip	:	20837-2181
Country	:	US
Telephone Number	:	443-629-3761
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 SAINT JOHNS LN
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2605
Country	:	US
Telephone Number	:	443-629-3761
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2005
Last Update Date	:	08/12/2021

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